Provider Demographics
NPI:1609149616
Name:WAITE, DANIEL (CPED)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:WAITE
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5152 MORRISH RD
Mailing Address - Street 2:APT 60
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1379
Mailing Address - Country:US
Mailing Address - Phone:989-666-3880
Mailing Address - Fax:
Practice Address - Street 1:5152 MORRISH RD
Practice Address - Street 2:APT 60
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1379
Practice Address - Country:US
Practice Address - Phone:989-666-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist